Utilization management jobs in Melrose, NYCreate job alerts

Department/Unit: Education And Develop Work Shift: Day (United States of America) Salary Range: $71,547.00- $118,053.00 The Education Specialist is expected to utilize their knowledge and skills to accomplish the goals of the organization. The Education Specialist achieves this goal through t...

Managing a patient panel with a broad array of patient needs; conducting a mix of acute, chronic ... Utilization of your specific clinical training and opportunities to perform in-office procedures

Clinical pathway, Navigator, or Utilization Review. Shift(s) available: day shift and mid shift Job ... management, preferably within a healthcare or hospital setting Exceptional interpersonal and ...

Coordinate with Utilization Management (UM) department on concurrent and retrospective review. Follow up with assigned nurses for clinical updates to care plan. Document within two business day ...

Supporting managed care initiatives, utilization management, and clinical model design. Qualifications: * Experience: 3+ years in staff supervision, value-based care, or managed care settings

REGISTERED NURSE The Registered Nurse reports to the Nurse Manager. This position provides ... to ensure optimal utilization of services. * Ensure quality standards set by the external ...

Complete Readmission screen in the Care Management Module (CarePort). * Conduct Utilization review via Chart Review. * Conduct timely concurrent reviews and responses to third party payors request ...

This CARM role will manage a team responsible supporting SPGI's acquisition, utilization, and distribution of market data sourced from stock exchanges globally. The primary focus will be to review ...

Meet regularly with the Behavioral Health Manager and Chief Behavioral Health Officer. * Consult ... Participate in Utilization reviews and remaining available for emergency consultations. • Analyze ...

Responsible for case management and patient care delivery through nursing assessment, nursing intervention, patient education, patient care coordination and utilization of referral services, as part ...

Exhibit strategic thinking and sound decision-making thorough knowledge and utilization of business ... Manages all sale

... management of members with chronic and/or catastrophic illness, members who are frail elderly and ... Combine utilization of medical care and pharmacy, with specific focus on the transition of care ...

The NP is responsible for managing protocols for study subjects enrolled in therapeutic and non ... Familiarity with database utilization, regulatory compliance and human subject's protection issues

Coordinate with Utilization Management (UM) department on concurrent and retrospective review. * Follow up with assigned nurses for clinical updates to care plan. * Document within two business day ...

Coordinate with Utilization Management (UM) department on concurrent and retrospective review. * Follow up with assigned nurses for clinical updates to care plan. * Document within two business day ...

The Nurse Manager (RN) will: * In conjunction with the DON and HR Manager, recruit, hire, monitor ... Monitor utilization of nursing services and staffing productivity * Provide clinical nursing ...

Case management: 1 year (Preferred) License/Certification: * RN (Required) Work Location: On the road, field based.

Experience in case management preferred. * Certifications: * Case Management Certification (CCM or ACM) preferred or willingness to obtain. * Skills: * Strong clinical knowledge * Excellent ...

Provides high quality nursing care to meet the needs of the patient and manages/coordinates the delivery of multidisciplinary health care services for a caseload of patients. We are an equal ...

Job Overview - RN Case Manager (MLTC) Step into a key role as an RN Case Manager with our client, supporting MLTC members throughout the Bronx and Westchester, NY. This hybrid role combines remote ...

This position coordinates with Care Management Team (CMT) to maintain efficient and effective operations of Healthfirst's long term care plans such as CompleteCare and Senior Health Partners. Duties ...

The position may also serve as a Case Manager to a group of assigned Wound Care Center patients, as assigned and depending on the Wound Care Center setup. All Healogics employees must perform their ...

The Home Health RN manages patient care in home settings, conducting assessments, coordinating with physicians, and delivering skilled nursing care. Qualifications: * Graduate of an accredited ...

Effectively provides oversight and coordination of paraprofessionals in the home setting and may act as the Supervisor in the absence of the Supervisor or Nurse Manager as applicable in accordance ...